Stroke Patient Characteristics Associated with 30-day Hospital Readmissions: A Retrospective, Intra-hospital network Study
Kevin Spiegler1, Hannah Irvine1, Jose Torres1, Myrna Cardiel1, Ariane Lewis1, Koto Ishida1, Steven L. Galetta1, Kara Melmed1
1Neurology, NYU Langone Health
Objective:

The objective of this study was to identify risk factors associated with 30-day hospital readmission in patients admitted with stroke in a major urban hospital network.

Background:

Hospital readmissions are associated with poor health outcomes for patients including illness severity and medical complications. Additionally, there is significant accompanying cost to the patient and resource burden to the medical field. We aimed to determine specific patient features associated with risk for readmission in our stroke patient population.

Design/Methods:
We collected data on all patients admitted with stroke who were readmitted to the hospital within 30 days of discharge from Jan 2016 to Dec 2017 and compared them to a randomly selected subset of non-readmitted stroke patients during the same time period matched by discharge location. Chart review was used to collect data, including demographics, characteristics of the stroke itself, co-morbid conditions prior to hospitalization, in-hospital complications, and non-pharmacological interventions aimed at reducing risk for readmission. We compared each measurement across readmission status using univariate statistics.
Results:

In total, 130 readmitted stroke patients were compared to 110 stroke patients who were not readmitted. Readmission was associated with presence of hemorrhagic stroke (OR = 2.62, 95% CI [1.21, 5.7], p = 0.013), history of malignancy (OR = 3.33, 95% CI [1.38, 8.07], p = 0.005), history of dementia (OR = 3.59, 95% CI [1.30, 9.97], p = 0.010), and not receiving a hospital follow-up call after discharge (OR = 0.41, 95% CI [0.23, 0.73], p = 0.012). There was no difference in age, sex, race or insurance status between readmitted and non-readmitted patients (p > 0.27).

Conclusions:

These data may be used to identify stroke patients at risk of requiring hospital readmission and could be used to prioritize interventions in these specific populations.

10.1212/WNL.0000000000202486